Published online August 6, 2007
PEDIATRICS Vol. 120 No. 3 September 2007, pp. e543-e547 (doi:10.1542/10.1542/peds.2006-3613)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Atkinson, A. R.
Right arrow Articles by Roifman, C. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Atkinson, A. R.
Right arrow Articles by Roifman, C. M.
Related Collections
Right arrow Infectious Disease & Immunity
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

ARTICLE

Low Serum Immunoglobulin G2 Levels in Infancy Can Be Transient

Adelle R. Atkinson, MD and Chaim M. Roifman, MD

Division of Immunology and Allergy, Canadian Centre for Primary Immunodeficiency, Jeffrey Modell Research Laboratory for the diagnosis of Primary Immunodeficiency, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada

OBJECTIVE. The immunoglobulin G2 subclasses contain predominantly antipolysaccharide antibodies. It was therefore believed intuitively that low immunoglobulin G2 levels could predispose individuals to infections with encapsulated bacteria. Although many reports initially supported this notion, more recent studies challenged it. Regardless of the biological significance, the natural history of low immunoglobulin G2 levels has not been carefully studied.

METHODS. We studied the outcome of low serum immunoglobulin G2 subclass levels in children. Thirteen patients who were referred because of recurrent infections were found to have low immunoglobulin G2 levels. Laboratory evaluation at presentation and follow-up visits included total serum immunoglobulins, immunoglobulin subclasses, and specific antibodies to protein antigens and to pneumococcal vaccine.

RESULTS. Low immunoglobulin G2 levels resolved completely within 0.6 years to 6 years (median: 1.5 years) in all patients. All 13 patients responded adequately to vaccination with protein antigens such as tetanus toxoid and polio as well as to immunization with pneumococcal vaccine. Four of 13 patients had a previous history of transient hypogammaglobulinemia, raising the possibility that the other cases may simply represent the tail end of this condition.

CONCLUSION. We have demonstrated that low immunoglobulin G2 detected in early infancy and childhood is likely to resolve completely within several months and up to 6 years from the time of presentation.

Key Words: primary immunodeficiency • immunoglobulin IgG subclasses • childhood • infections

Abbreviations: IgG—immunoglobulin G • IgA—immunoglobulin A • IgM—immunoglobulin M • PCP—pneumococcal capsular polysaccharide

Accepted Mar 22, 2007.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?